1043-3155 Pediatr Neurol Briefs pedneurbriefs Pediatr Neurol Briefs Pediatric Neurology Briefs Pediatr Neurol Briefs 2166-6482 1043-3155 2166-3155 Pediatric Neurology Briefs Publishers Chicago, IL, USA PNB-7-45-b 10.15844/pedneurbriefs-7-6-7 Seizure Disorders Neurology Pediatrics Nervous System Diseases Child Development Brain Diseases Neurosurgery Child Infant Carbamazepine and Serum Lipid Levels http://orcid.org/0000-0002-0173-7931 Millichap J. Gordon MD 1 2 * Division of Neurology, Children's Memorial Hospital, Chicago, IL Departments of Pediatrics and Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL Correspondence: Dr. J. Gordon Millichap, E-mail: jgmillichap@northwestern.edu 06 1993 01 07 2016 7 6 45 46 Copyright: © 1993 The Author(s) 1993 This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Serum lipid levels during carbamazepine medication. A prospective study

The effects of carbamazepine on serum lipid levels in 36 previously untreated patients with recently diagnosed idiopathic epilepsy were evaluated in a 1 to 5-year follow-up study at the Departments of Neurology and Clinical Chemistry, University of Oulu, Finland.

 High-Density Lipoprotein G-Glutamyltransferase Triglycerides

The effects of carbamazepine on serum lipid levels in 36 previously untreated patients with recently diagnosed idiopathic epilepsy were evaluated in a 1 to 5-year follow-up study at the Departments of Neurology and Clinical Chemistry, University of Oulu, Finland. Serum cholesterol, high-density lipoprotein (HDL) cholesterol, and g-glutamyltransferase (GGT) levels increased after 2 months’ carbamazepine treatment and remained high after 1 and 5 years follow-up. Cholesterol/HDL cholesterol ratios remained unchanged. Serum low-density lipoprotein (LDL) cholesterol and triglycerides (TG) increased during the first year but were normal after 5 years on medication. The change in lipid metabolism may be associated with induction of liver enzymes during carbamazepine treatment for epilepsy, and may also have clinical relevance to the increased incidence of atherosclerosis and coronary heart disease in patients with epilepsy. [1]

COMMENT. The data support the hypothesis that the increase in serum cholesterol levels during carbamazepine therapy for epilepsy may be associated with liver enzyme induction. The changes in serum lipids may also be a consequence of hormonal effects, notably a decrease in free thyroxine, observed with carbamazepine. Patients receiving carbamazepine should have base line lipid profiles and serum lipid monitoring. Carbamazepine may not be an adjunct drug of choice in children receiving the ketogenic diet for refractory epilepsy.

An elevation of very long chain fatty acids found in 13 of 22 plasma samples from patients on a standard ketogenic diet for uncontrolled seizures may lead to diagnostic confusion with peroxisomal disorders. Valproic acid was taken by 5 of the patients tested. [2]

 Isojärvi JI Pakarinen AJ Myllylä VV Serum lipid levels during carbamazepine medication. A prospective study Arch Neurol 1993 Jun 50 6 590 3 8099275 10.1001/archneur.1993.00540060030012 Theda C Woody RC Naidu S Moser AB Moser HW Increased very long chain fatty acids in patients on a ketogenic diet: a cause of diagnostic confusion J Pediatr 1993 May 122 5 Pt 1 724 6 8496750 10.1016/S0022-3476(06)80013-2